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General NPI Number Information
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NPI Number | 1144273988
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Entity Type | Organization
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Legal Business Name | PAUL J ALLEN MD PLLC
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 09/07/2012
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Provider Practice Location Address
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Address Line | 2938 LIMITED LN NW STE B
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City | OLYMPIA
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State | WA
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Zip | 98502
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Country | US
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Telephone | 360-352-8800
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 12840
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City | OLYMPIA
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State | WA
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Zip | 98508-2840
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Country | US
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Telephone | 360-352-8800
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN OWNER
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Name | DR. PAUL J ALLEN
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Credential | MD
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Telephone | 360-352-8800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | MD00027976
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License Number State | WA
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